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Sector questions controversial NMS finding

Numark director of pharmacy services Mimi Lau disagrees that small chains are better than independents at delivering the NMS

Contractor representatives (including Numark's Mimi Lau, pictured) refute Nottingham University's conclusion that small chains are better than independents at delivering the NMS

Industry leaders have questioned research that suggests small multiples are better at delivering the new medicine service (NMS) than independent pharmacies.

Independent contractors had delivered the service "exceptionally well", pharmacy leaders said in response to last week's evaluation by Nottingham University, which found that NMS patients were almost twice as likely to be more adherent to their medicines if the service was provided by a small multiple rather than an independent.

The evaluation - which looked at 12 independent pharmacies, 14 small multiples, 19 large multiples and one supermarket – found that pharmacy chains were "more capable of rolling out the NMS" while independents did "not necessarily see an alignment" between the service and their approach to community pharmacy. 

The research produced "inconclusive" data on the adherence rates of patients at larger multiples or supermarkets, the researchers added.

Pharmacy Voice chief executive Rob Darracott told C+D that "too much" was being made of the evaluation's reference to the success of small multiples, as the limited number of pharmacies analysed made it hard to reach specific conclusions.

"Nearly half the patients came to small multiples [and] the numbers are quite small," he said.

Numark director of pharmacy services Mimi Lau said it was "not the case" that small chains were better than independent pharmacies at engaging with the NMS.

"Independents can react quickly and they've got the attitude and the team behind them. It was a generalised evaluation [and] in reality you've got multiples that are not doing so well," Ms Lau told C+D. 

Nick Hunter, secretary of Doncaster, Rotherham and Nottinghamshire LPCs, agreed that some independent pharmacies had "really got behind" the NMS and were able to rapidly respond to changing priorities.

Mr Hunter suggested the evidence from the evaluation that some independents may have struggled to deliver the service could be the result of a tough economic climate and said it would be "interesting" to investigate this issue further.

Independent Pharmacy Federation chief executive Claire Ward told C+D that independents had a good relationship with their patients and would find it easier to deliver the NMS if it was commissioned permanently as a "core NHS service".

But Amanda Smith, manager of Heath Pharmacy in Halifax, said it was a "fair point" that multiples were doing a better job at delivering the service then independent pharmacies such as her own.

"We did start off enthusiastically but because you have to meet certain targets to get paid, we went off it. We're just a single shop and have found it difficult," Ms Smith told C+D.

The evaluation showed that the NMS "significantly" improved medicines adherence and saved the NHS money, the researchers from Nottingham University said. The most successful pharmacies at recruiting patients for the service had a cohesive team and a "clear can-do attitude", they said.

Do you think that multiples are more effective at providing NMS than independents? 

We want to hear your views, but please express them in the spirit of a constructive, professional debate. For more information about what this means, please click here to see our community principles and information

Meera Sharma, Community pharmacist

This finding is hardly surprising - the multiples have got targets and woe behold the employee pharmacist not doing their set numbers! While the independent pharmacy has got a business he/she is trying to keep afloat given the current state of pharmacy - surely, they will focus on tasks that are viable. NMS in it's current set-up is not viable from a business point of view. Good concept, bad set-up. Please put this research conclusion into context!

R Patel, Community pharmacist

. I wonder how many of these well performing pharmacies are those within the premises of these Health centres with several surgeries . They are the ones who get the first scripts of new items and so can provide the NMS.
Small independents near them miss out and maintain the repeats ie if the patient hasn'tt been now nominated by the in house pharmacy.

N O, Pharmaceutical Adviser

Why research ? You want to talk business? Here it is -- 1 completed NMS = minimum of £20 = minimum of 22.22 Prescription items = 5 patients with 4.4 items.

Now you workout your business and see if it makes sense or not. I can only call it simply laziness in not providing this service and all other reasoning are lame excuses. How many times have a patient advices resulted in to sale? Even then we provide an ear to those customers who just want your advice, don't we? Then what's wrong in providing this service that pays you in return?

London Locum, Locum pharmacist

What is the guaranteed number of NMS you will get in any given month? I think you"ll find Prescription items are a much surer source of income than NMS. Right now no Viable Pharmacy business can have it's foundation built on services.
I'm a simpleton and even I know this.

[email protected], Pre-reg graduate

Well said. If I may add, this consultation ranges between 5 to maximum 10 min on sign-up and then just over a minute for subsequent appointments if you call them. For this you get paid £20+ !!! Even then there are people against the service? What a shame on our profession. Does this group of people include those pharmacists who are more than happy to tick few boxes and handout calpol under the Minor Ailment Scheme? and those who are happy to use resources in explaining how happening is the new perfume section they have just filled with along side the Rimmel stand?

London Locum, Locum pharmacist

What if none or very few of your patients are new starters on the NMS meds??

Dave Downham, Manager

...which is why the max # NMS is 0.5% of eligible items, as it's not expected that every Rx with be NMSable. You're right that services can't be the foundation of a business, but it sure as heck can assist in adding to the bottom line and make Mrs Jones think that pharmacists have other skills than knowing the 28 times table.

[email protected], Pre-reg graduate

What if all the medical conditions are cured overnight?

London Locum, Locum pharmacist

Not a very sensible comparison

R A, Community pharmacist

Its probably because independents could not identify any legitimate case for NMS case whilst pharmacist for multiples petrified of reaching target so will provide NMS for medication which probably is not necessary.

Gerry Diamond, Primary care pharmacist

Mimi Lau........*....dont make me laugh offered no empirical evidence to back up her clain. Well industry leader do a service evaluation or commission one for crying out loud..*

*This comment has been edited according to the community priniciples - C+D

Gerry Diamond, Primary care pharmacist

Mimi Lau........*....dont make me laugh offered no empirical evidence to back up her clain. Well industry leader do a service evaluation or commission one for crying out loud..*

*This comment has been edited according to the community priniciples - C+D

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